A Minimally Invasive, Translational Method to Deliver Hydrogels to the Heart Through the Pericardial Space

Abstract

Visual Abstract

Implantable Therapeutic Reservoir Systems for Diverse Clinical Applications in Large Animal Models

“…[ 47,48 ] As treatment paradigms evolve to include cell and biomaterial‐based therapies to improve heart function, novel delivery strategies are necessary to deliver these treatments. [ 2 ] Although alternative strategies have been devised for delivery of biomaterials and cells to the heart in minimally invasive fashion, including a biodegradable polymer reservoir, [ 35 ] a hydrogel patch, [ 49 ] and a flexible injection catheter, [ 50 ] a refillable depot that can be secured to the heart has not yet been established. The c‐Regenervoir system aims to address this unmet need, by creating a multidepot reservoir that wraps around the left ventricle to secure focal delivery of therapeutic cargo.…”

Minimally Invasive Delivery of Hydrogel-Encapsulated Amiodarone to the Epicardium Reduces Atrial Fibrillation

“…Recently, we described a catheter-based technique using a novel device to deliver hydrogels to the cardiac epicardium under fluoroscopic guidance 20 . This delivery technique creates a temporary compartment on the heart’s surface for hydrogel delivery and in situ polymerization allowing precise localization and gelation.…”

Pericardial Delivery of Biological Agents

“…There are some limitations to the described approach by Garcia et al. (12) worth highlighting. Patients who have had prior cardiac surgeries are likely to have pericardial adhesions, thus limiting pericardial access.…”

“…In this issue of JACC: Basic to Translational Science , Garcia et al. (12) examined the effectiveness of a new biomaterial pericardial delivery catheter in a porcine model. The device consists of 2 internal lumens to maintain biomaterial components separate during delivery.…”

“…The development of this device described by Garcia et al. (12) proves to be a promising step toward acceleration in the growth of HF therapies that require direct injection or contact with the myocardium; however, recent hydrogel and stem cell therapies require intramyocardial access that cannot yet be performed with this device (12) . More trials with a larger number of patients are required to demonstrate the safety of a “dry” pericardial access and efficacy of delivery of biologically active agents with this device.…”